The clinical characteristics and short-term prognosis in elderly patients with Guillain-Barré syndrome

Abstract

To investigate the clinical characteristics and short-term prognosis of elderly patients with Guillain-Barré syndrome (GBS). We retrospectively analyzed the clinical data of adult GBS. According to the age, the enrolled subjects were divided into 2 groups, that is, patients ≥60 years (elderly group) and those aged 18 to 59 years (nonelderly group). The clinical characteristics and shortterm prognosis of the patients in the 2 groups were compared. In total, 535 patients were enrolled. There were 67 patients fell into the elderly group with a mean age of 69 years old; while 468 patients fell into the nonelderly group with a mean age of 39 years old. We found that the elderly patients had significantly lower incidence of antecedent infections (49.3% vs 66.2%, P<0.01). The time from onset to admission (5 vs 4 days, P<0.05) and time from onset to nadir (7 vs 6 days, P<0.05) were significantly longer in the elderly patients. It was noteworthy that more elderly patients were found with lymphocytopenia (55.4% vs 37.3%, P<0.01), hyponatremia (25.0% vs 10.2%, P<0.01), hypoalbuminemia (9.0% vs 2.6%, P<0.05), and hyperglycemia (34.3% vs 15.2%, P<0.01). Importantly, the elderly patients had longer duration of hospitalization (17 vs 14 days, P<0.05), higher incidence of pneumonia (29.9% vs 18.8%, P<0.05), and poorer short-term prognosis (58.2% vs 42.7%, P<0.05). In patients with severe GBS, no significant differences were observed in disease severity, treatment modality, incidence of pneumonia, and duration of hospitalization between the 2 groups. However, more patients in the elderly group showed poor short-term prognosis (84.1% vs 63.8%, P<0.01). Further, old age (≥60 years) (OR=2.906, 95% CI: 1.174.7.194, P<0.05) and lower Medical Research Council (MRC) score at nadir (OR=0.948, 95% CI: 0.927.0.969, P<0.01) were risk factors for poor short-term prognosis in severe GBS patients. The clinical characteristics and short-term prognosis of elderly patients with GBS are distinct from nonelderly adults. Old age (≥60 years) and lower nadir MRC score serve as predictor for poor short-term prognosis in severe GBS patients.